PMS: How Much Do We Really Know? Essay

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PMS: How Much Do We Really Know?


"Basically, PMS has been piecemealed. It's like the story of the five blind men and the elephant. One checked the trunk, another the leg and so on, but nobody has the full picture." --Dr. Susan Thys-Jacobs (1).

The Controversy

There has been much controversy over the biological factors involved in the mood disorders and discomfort felt by countless women before the onset of menses. The common term for this discomfort is pre-menstrual syndrome (PMS). PMS is a disorder involving hormonal changes that trigger disruptive symptoms up to two weeks prior to menstruation. While for many women the symptoms are not severe enough to require treatment, 12 % (5 out of 40 million) are medically treated for
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Hormones
Withdrawal theory

Dr. Sheryl Smith and colleagues in Philadelphia have devised a theory hypothesizing that PMS is caused by withdrawal of a woman's own hormones. The progesterone levels are increased during the second half of the menstrual cycle, and then there is a dramatic drop right before the premenstrual period. Progesterone, however, is converted to alopregnanolone, which acts like a sedative, increasing the potency of Gamma amino buteric acid (GABA). The presence of GABA produces mild euphoria. This theory hypothesizes that it is the sudden decrease that creates feelings of depression. The body, in effect, goes into withdrawal. She conducted an experiment in which rats were administered progesterone for three weeks and then induced them into withdrawal (both progesterone and alopregnanolone). As a result, the rats became more anxious. Studying the brain of these rats showed that this withdrawal changed the socket into which GABA connects, preventing GABA from calming the brain as it usually does. To counteract this effect, they used a substance which inhibited this outcome, and concluded that they could block the behavioral effects of the progesterone withdrawal. The implications for this hint at the need to create a drug that accomplishes the same results in humans (3).

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